Berstad A, Hatlebakk J G, Wilhelmsen I, Berstad K, Bang C J, Nysaeter G, Hausken T, Weberg R, Nesje L B, Hjartholm A S
Department of Medicine, Haukeland University Hospital, Bergen, Norway.
Hepatogastroenterology. 1995 Sep-Oct;42(5):655-9.
BACKGROUND/AIMS: From Dec. 1990 to Jan. 1993 we treated 306 patients with chronic peptic ulcer disease and gastric Helicobacter pylori infection with one of three triple therapy regimens comprising bismuth subnitrate suspension (B) 15 mg/ml, oxytetracycline (OT), and metronidazole (M).
Treatment I (101 patients): B 5 ml, OT 500 mg, and M 200 mg, all q.i.d. for 14 days. Treatment II (60 patients): B 10 ml and OT 750 mg q.i.d., M 400 mg t.i.d. for 7 days. Treatment III (145 patients): B 10 ml and OT 500 mg q.i.d., M 400 mg t.i.d. for 10 days. Gastroscopy and 14C-urea breath test were performed 4 weeks and 1 year after cessation of therapy.
According to the urea breath test, H pylori eradication rates at 4 weeks were 87.9%, 81.9%, and 95.0% for Treatment I, II and III, respectively. At one year, 4 out of 242 patients, who were H pylori negative at 4 weeks, had become H pylori positive, i.e., H pylori reinfection rate 1.7%, 95% CI 0.5-4.2%. Only one of these "reinfected" patients had ulcer recurrence. Another patient had duodenal ulcer recurrence shortly after cessation of treatment in spite of being H pylori eradicated, i.e., ulcer recurrence rate 0.8%, 95% CI 0.1-3.0%.
During the first year after H pylori eradication by triple therapy, recurrence rates of H pylori infection and peptic ulcer are very low (below 4.2% and 3.0%, respectively).
背景/目的：1990年12月至1993年1月，我们采用三种三联疗法之一治疗了306例患有慢性消化性溃疡疾病和胃幽门螺杆菌感染的患者，这三种疗法均包含15mg/ml的次硝酸铋悬浮液（B）、土霉素（OT）和甲硝唑（M）。
治疗方案I（101例患者）：B 5ml、OT 500mg和M 200mg，均每日4次，共14天。治疗方案II（60例患者）：B 10ml和OT 750mg每日4次，M 400mg每日3次，共7天。治疗方案III（145例患者）：B 10ml和OT 500mg每日4次，M 400mg每日3次，共10天。在治疗结束后4周和1年进行胃镜检查和¹⁴C尿素呼气试验。
根据尿素呼气试验，治疗方案I、II和III在4周时的幽门螺杆菌根除率分别为87.9%、81.9%和95.0%。在1年时，242例在4周时幽门螺杆菌阴性的患者中有4例变为幽门螺杆菌阳性，即幽门螺杆菌再感染率为1.7%，95%置信区间为0.5 - 4.2%。这些“再感染”患者中只有1例出现溃疡复发。另1例患者尽管幽门螺杆菌已被根除，但在治疗结束后不久出现十二指肠溃疡复发，即溃疡复发率为0.8%，95%置信区间为0.1 - 3.0%。
在通过三联疗法根除幽门螺杆菌后的第一年，幽门螺杆菌感染和消化性溃疡的复发率非常低（分别低于4.2%和3.0%）。
